Category Archives: Preparedness
Study: New Requirements Needed for Hand Hygiene for Anesthesia Providers
Anesthesia providers frequently miss identified opportunities to clean their hands during surgical procedures, with the points immediately before patient contact and immediately after contact with the patient’s environment the times when they are least likely to practice proper hand hygiene, according to a new study in the American Journal of Infection Control. However, the findings also point to a larger problem: Complete compliance with all hand hygiene guidelines would take so much time that there would be no time to actually perform any procedures. The findings indicate “a need to create more practical—but still effective—methods of controlling bacterial transmission in anesthesia work environments.” Read more on prevention.
HHS: $840M to Help State, Local Agencies Improve Disaster Preparedness
The U.S. Department of Health and Human Services (HHS) has awarded approximately $840 million in grants to help state and local public health and health care systems improve their emergency response preparedness. Distributed through the Hospital Preparedness Program (HPP) and the Public Health Emergency Preparedness (PHEP) program, the funds will ensure that communities are prepared to respond to an array of emergencies, including infectious disease outbreaks, natural disasters, or chemical, biological, or radiological nuclear events. “Community and state preparedness is essential to the health security of all Americans,” said Nicole Lurie, MD, assistant secretary for preparedness and response (ASPR), in a release. “Events in the last few years have demonstrated how critical it is for health systems across the country to be ready and able to respond quickly and effectively.” Read more on disasters.
ACP: Annual Pelvic Exams Not Needed for Asymptomatic Women
Annual pelvic exams for women do more harm than good and should not be a routine part of health care for women who are not pregnant or who show no other signs of pelvic problems, according to new guidelines from the American College of Physicians (ACP). In a review, researchers found no studies on the effectiveness of pelvic exams in identifying cancers, infections and other health issues that they are commonly used to find. Researchers stressed that their findings only apply to pelvic exams and that women should still undergo recommended cervical cancer screening. Read more on prevention.
During Hurricane Katrina, volunteers at American Red Cross shelters in the Gulf region noticed a pattern among some of the young children settling in as the storm began: They had brought pillowcases from home filled with some of their most precious items, such as a favorite book or a devoted stuffed animal. Other volunteers learned that evacuating college students also carried their belongings in pillowcases.
Following the storm, chapters along the Gulf launched a pilot called the “Pillowcase Project” that earlier this year became a national program of the American Red Cross, sponsored by the Walt Disney Company. Chapters across the country and in several pilot countries are now adapting the project to teach preparedness to children in grades 3 to 5 at school, after school and in camp settings.
“We’re working hard to get kids involved in preparedness,” said Jim Judge, a member of the American Red Cross Scientific Advisory Council. Judge said getting kids involved helps dispel some of the fear they may face as they evacuate to avoid a disaster, “but we’ve also found that if you get the kids involved, often times they go home and get the parents involved [as well].”
But why a pillowcase? “Just about every home has a pillowcase, it’s inexpensive, you can decorate it and it’s a simplified way of getting kids involved,” he said.
In the pilot programs, kids get the pillowcases and supplies such as a mini first-aid kit, a glow stick, an activity book and crayons, all of which they use to start their own personalized disaster kit and preparedness plan. As part of the program, they learn about the types of emergencies that can impact their community and then they do a physical activity—such as leaving the building—to reinforce what they’ve learned. Afterward they talk about the lessons in small discussion groups.
“The hands-on activities will also help to build confidence so that kids are prepared to take action during an emergency,” said Francisco Ianni, who oversees Red Cross youth readiness programs throughout Oregon and Southwest Washington State.
>>Bonus Link: Watch a pillowcase presentation to a group of young students
One of the key lessons of Hurricane Sandy—which caused massive destruction in New York and New Jersey, two states that don’t usually see that kind of weather devastation—is that disasters can strike anywhere. That’s the thinking behind a new exhibit at the National Building Museum in Washington, D.C., Designing for Disaster, which brings together objects, video, photos and interactive components to show that policies, plans and designs can result in safer, more disaster-resilient communities.
A key goal of the exhibit is to share ideas for building and rebuilding. In a recent interview posted on the museum’s website, the exhibit’s curator, Chrysanthe Broikos, asks “as we face an increasing number of destructive and deadly natural disasters...should we have the right to build exactly what we want, where we want, no matter the risks? Should we give more thought to the long-term viability and protection of the structures and communities we build?”
Those are policy discussions underway right now, and some suggestions are being shared in a “disaster mitigation” blog launched to complement the exhibit. The blog invites building and disaster experts to post their ideas and thoughts on how to make us all more disaster-resilient.
The exhibit highlights current work by planners, engineers, designers, emergency managers, scientists, environmentalists, business leaders and community leaders, some viewable in a short video on the exhibit. For example, constructed just for the exhibit is a Federal Emergency Management Agency (FEMA) “safe room” that would be highly protective if a tornado struck. But the exhibit asks the necessary questions, as well. For example: What if requiring safer construction makes housing unaffordable for many?
While many of the exhibit designs are experimental, the museum’s website also offers resources to learn about steps individuals can take in their own homes and communities to prepare for disasters, remain safe and prevent damage. FloodSmart, for example, is a FEMA resource which lets users see how much damage flooding can cause, assess flood risk and learn about flood insurance.
>>Bonus Link: On June 24, the National Building Museum will hold a competition, Rebuild by Design, that challenges contestants to envision rebuilding designs for communities devastated by Hurricane Sandy.
Recovery after a disaster can take years or even decades—but what most people don’t realize is that recovery starts even before the disaster occurs. Resilience is about how quickly a community bounces back to where they were before a public health emergency—and only a healthy community can do that effectively.
NewPublicHealth recently spoke with Alonzo Plough, PhD, MPH, Vice President, Research-Evaluation-Learning and Chief Science Officer at the Robert Wood Johnson Foundation, about taking steps toward recovery even before a disaster occurs.
NewPublicHealth: What are some important aspects of preparedness that help prepare responders and the community for recovery from a disaster?
Alonzo Plough: Connectivity between organizations, between neighbors, between communities and formal responder organizations is absolutely critical to building community disaster resilience. This allows recovery to go more smoothly because the partners who have to work together in recovery have been working together and connecting to communities prior to a disaster event. Managing the long tail of recovery is easier if there has been recovery thinking in the preparedness phase.
NPH: One of the issues for the panel at the recent Preparedness Summit is the impact of the news spotlight when a disaster occurs, and then the impact of that spotlight turning off. How does that focus impact recovery?
Plough: Often the initial media frames are to wonder why there weren’t preventive mechanisms. In the case of the mudslides in Washington State, for example, why weren’t there zoning restrictions or regulatory restrictions? That initial media frame often will point a finger to ask why houses were allowed to be built in an at-risk location. Why were building permits given at all?
But none of that really addresses the long-term issues of communities working toward recovery, regardless of the specific event. There is a disruption of life as people know it in a disaster that goes on for a long, long period of time. The media doesn’t really capture the complexity of that while they’re focused on the short-term outcomes. When the media focus goes away, the appropriate agencies and organizations who need to be engaged continue their engagement.
Millions of people have now seen their phone shake and heard it wail with news of an impending tornado or other disaster. Two years ago the wireless industry rolled out a free service known as wireless emergency alerts, and wireless carriers representing more than 98 percent of subscribers agreed to participate.
People with older phones, however, may not be able to access the alerts. Brian Josef, general counsel for the CTIA—The Wireless Association in Washington, D.C., recommends checking for the capability when buying a new phone and. For your current phone you can check with your carrier’s customer service office to see whether you automatically get the alerts.
People who can’t receive the texts, or who want a double layer of information, can sign up with local emergency management offices and get alerts via phone, text, email and in some cases Twitter—although sessions at the recent Preparedness Summit in Atlanta indicated that while Twitter is growing, it is still not used by many local and state health departments. Check the bottom of your health department home page to find the Twitter handle, if there is one.
Josef also points out that you may find that a neighbor got an alert and you didn’t—but that’s because the alerts are geo-targeted. If you and your neighbor were a few miles away from each other when an alert went out, only the one in harm’s way would get pinged.
But the apps won’t do you much good if your phone loses its charge. Preparedness experts recommend keeping a charged extra battery and portable charger on hand, and some emergency radios also include phone/device chargers.
Other tips to conserve your smartphone battery, according to Mary Clark, Chief Marketing Officer of the mobile technology company Syniverse, include:
- Reduce the brightness of your screen
- Close unnecessary apps
- Use text messages to communicate with friends and family
- Send an initial text to those most important detailing your plans
- Turn off unneeded options such as Wi-fi and Bluetooth
HUD Awards $40 Million in Housing Counseling Grants
The U.S. Department of Housing and Urban Development (HUD) has awarded more than $40 million in grants to hundreds of national, regional and local organizations to help families and individuals with their housing needs and to prevent future foreclosures.
“HUD-approved counseling agencies use this funding to support a wide range of services from assisting lower income persons to locate an affordable apartment to helping first-time homebuyers avoid unsustainable mortgages,” said Secretary of Housing Shaun Donovan.
More than $38 million will directly support the housing counseling services provided by 29 national and regional organizations, seven multi-state organizations, 22 state housing finance agencies and 232 local housing counseling agencies. In addition, HUD is awarding $2 million to three national organizations to train housing counselors with the instruction and certification necessary to effectively assist families with their housing needs.
In 2012, HUD released two reports on the impact of HUD-approved housing counseling for families who purchase their first homes and those struggling to prevent foreclosure. In both studies, HUD found housing counseling significantly improved the likelihood homeowners remained in their homes.
Read more on housing
Chest Pain Incidence Drops for Whites, But not for Blacks
The percentage of people reporting angina (chest pain) dropped in the last two decades among Americans 65 and older and white people 40 and older — but not among black Americans, according to a study in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.
Angina is chest pain or discomfort that occurs when the heart isn’t getting enough oxygen-rich blood.
Researchers analyzed national health survey data starting in 1988 to find how many patients reported that a health care professional had told them they have the condition and how many people report angina symptoms.
- The rates for whites 40 and older reporting a history of angina dropped by about one-third, from the 2001-04 survey to the 2009-12 survey.
- The rates for whites 40 and older reporting angina symptoms declined by half from the 1988-94 survey to 2009-12 survey.
- For blacks, the rates were essentially unchanged.
- The rates for American women 65 and older reporting a history of angina dropped nearly in half from the 2001-04 survey to the 2009-12 survey.
- The rates for women 65 and older reporting angina symptoms declined by almost 60 percent from the 1988-94 survey to 2009-12 survey; the rates for men in this age group declined by more than 40 percent during this same time period
Read more on heart health
United States, Canada and Mexico Set Guidelines to Strengthen Information Sharing in Health Emergencies
The United States, Canada and Mexico have adopted a set of principles and guidelines on how the three countries’ governments will share advance public information and communications during health emergencies impacting the countries.
The Declaration of Intent calls on the three countries to:
- Share public communications plans, statements and other communications products related to health emergencies with each other prior to their public release;
- Apprise other appropriate authorities, depending on the type of health emergency, within their respective governments when the declaration is invoked;
- Conduct an annual short communications exercise to improve joint coordination; and
- Hold recurrent meetings to review and propose amendments to the Declaration of Intent.
Read more on preparedness
RWJF Issue Brief Explores Links Between Education and Health
Why is education such a major factor in shaping health? The links are tied closely to income and to the opportunities that people have to lead healthy lives, according to a new issue brief from the Robert Wood Johnson Foundation. Factors such as social networks, early childhood experiences and the type of neighborhood you live in all play a role in connecting education levels to health outcomes. The issue brief and video explore these connections and highlight their impacts through the perspectives of residents of a disadvantaged urban community in Richmond, Va. This is the second brief in a four-part series by the Virginia Commonwealth University Center on Society and Health’s Education and Health Initiative. Read more on education.
Parents with Kids in Car Often Engage in Distracted Driving
Parents with kids in tow are just as likely to engage in distracted driving practices as are drivers in the general population, according to a new study by researchers at the University of Michigan and published in Academic Pediatrics. The study, conducted in two hospital emergency rooms, found that 90 percent of parent drivers said they engaged in at least one of ten distractions examined in the study while their child was a passenger and the vehicle was moving. Distractions included talking on a cell phone, texting, giving a child food and picking up a toy that fell. Each year more than 130,000 children younger than 13 are treated in U.S. emergency departments after motor-vehicle collision-related injuries. The researchers also found that parents with higher education and who were non-Hispanic whites were more likely to report cellular phone and directions-related distractions such as use of navigation systems.
"If this finding is a result of greater access to technology among more highly educated and non-Hispanic white parents, we can expect the problem of technology-based distractions to expand because national rates of cell phone ownership in the U.S. have climbed above 90 percent," said Michelle L. Macy, MD, MS, an emergency medicine physician at the University of Michigan's C.S. Mott Children's Hospital. "Efforts to improve child passenger safety have often focused on increased and proper use of restraining seats. But this study shows that reducing distractions and discouraging unsafe behaviors could prevent crashes.” Read more on injury prevention.
SAMHSA Launches First Spanish-language Web Pages for National Prevention Week
The Substance Abuse and Mental Health Services Administration (SAMHSA) recently launched a series of new Web pages in Spanish to engage the Hispanic/Latino community in SAMHSA’s third annual National Prevention Week. The observance focuses on increasing public awareness of and action around substance abuse and mental health issues. New resources include instructions for participating in SAMHSA’s “Yo elijo” (“I Choose”) Project, Web badges and a 15-second promotional video in Spanish about the observance. Read more on substance abuse.
OSHA Urges Post-Storm Vigilance for Clean Up Workers and the Public
As much of the country begins the cleanup following massive storms since the weekend, the U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) is urging workers and the public to be aware of the hazards they can encounter and take necessary steps to stay safe. Storm and tornado cleanup work can involve hazards related to restoring electricity, communications, water and sewer services. Other hazards relate to demolition activities; cleaning up debris; tree trimming; structural, roadway and bridge repair; hazardous waste operations; and emergency response activities. Information on safe cleanup is available on OSHA’s website. Read more on preparedness.
Tornadoes Kill At Least 17 in South Central U.S. Over the Weekend
Multiple tornadoes, damaging winds and hail storms over the weekend resulted in 17 deaths in Arkansas and Oklahoma, according to reporting by the Weather Channel. More severe weather is expected in the South and Midwest through Wednesday. According to reporting by Reuters, the hardest hit area was Faulkner County in Arkansas, where 10 people died and cars and homes were destroyed. The Red Cross has opened several shelters in the area. Read about preparedness.
Study: Almost Half of Homeless Men Previously Suffered a Traumatic Brain Injury
Almost half of all homeless men who took part in a study by researchers at St. Michael’s Hospital in Toronto had suffered at least one traumatic brain injury (TBI) in their lives and 87 percent of those injuries occurred before the men lost their homes, according to the study authors. Some men suffered more than one TBI and the researchers found that assaults accounted for 60 percent of the injuries; sports and recreation accounted for 44 percent; and car accidents and falls accounted for 42 percent.
The fact that so many homeless men suffered a TBI before losing their home suggests such injuries could be a risk factor for becoming homeless, said lead researcher Jane Topolovec-Vranic, PHD, a clinical researcher in the hospital’s Neuroscience Research Program. Topolevec-Vranic said the study underscores the need to monitor young people who suffer TBIs such as concussions for health and behavioral changes. In men under age 40, falls from drug/alcohol blackouts were the most common cause of traumatic brain injury, while assault was the most common in men over 40 years old. The study was published in the journal CMAJ Open. Read more on injury prevention.
People on Statins More likely to Eat Foods that Can Lead to Obesity Related Illnesses
A new study led by researchers from UCLA suggests that people who took statins in 2009–10 were consuming more calories and fat than those who used statins 10 years earlier. There was no similar increase in caloric and fat intake among non-statin users during that decade according to the study in JAMA Internal Medicine. "We believe that this is the first major study to show that people on statins eat more calories and fat than people on those medications did a decade earlier," said the study's primary investigator, Takehiro Sugiyama, a visiting scholar at the David Geffen School of Medicine at UCLA. "Statins are used by about one-sixth of adults. We may need to reemphasize the importance of dietary modification for those who are taking these medications...”
The study authors used data from the National Health and Nutrition Examination Survey to compare fat and caloric intake among statin users and non-users in 1999–2000 and 2009–10. They found that caloric intake among statin users had risen by 9.6 percent over that decade and that fat consumption had jumped by 14.4 percent. In contrast, caloric and fat intake by non-statin users did not change significantly during the 10-year period. Read more on obesity.
In the wake of disasters communities often share stories of resiliency, not just to show how far they have come, but to model for others the critical need for an infrastructure of planning and preparedness when disaster hits. When the bombs went off at the Boston Marathon last year, Achilles International, a non-profit group that pairs able-bodied runners with disabled people, already had a chapter in place in the Boston area.
The group reached out using social media, as well as bright yellow banners and shirts during twice-weekly training sessions along the Charles River, to help attract attention and encourage Bostonian volunteers and potential athletes to join up. One survivor did. Thirty-one-year old Mery Daniel, a single mother of a five-year-old, who is close to completing her medical boards to become a general practitioner physician, lost one leg and suffered damage to the other during the blast. She joined up with Achilles and ran its 5K Hope and Possibility race—her first race ever—using a hand cycle last June.
The community rallying around the Boston Marathon over the last year has resulted in several new competitors joining up to compete in the Boston Marathon. A team of thirty differently abled Achilles runners, each with at least one guide for the race, will be wearing yellow Achilles shirts in today’s marathon. Their disabilities—ranging from Dwarfism and scoliosis to visual impairment—have not held them back.
“The stories about the survivors’ recoveries brought attention to the fact that people with disabilities have opportunities to do things they enjoy and learn new skills,” said Eleanor Cox, director of chapter development for Achilles. “So when the chapter put extra effort this past year into outreach through social media, word of mouth and the bright yellow banners on the Charles—matched up with people wanting to volunteer and people with disabilities wondering what was possible—it turned a previously quieter Achilles chapter into a strong one. Boston Strong.”
>>Bonus Link: Read more from Boston Marathon Survivor Adrianne Haslet-Davis on Recovery, Care, and Collaboration on the RWJF Culture of Health blog.
The U.S. Food and Drug Administration (FDA) was a partner agency for last week’s Preparedness Summit in Atlanta. NewPublicHealth spoke with Brooke Courtney, Senior Regulatory Counsel in the FDA Office of Counterterrorism and Emerging Threats, about how the agency plans for disasters it hopes never occur. Previously, Courtney was the Preparedness Director at the Baltimore City Health Department and in that role oversaw all of the public health preparedness and response activities for Baltimore City.
NewPublicHealth: What did you speak about at the Summit last week?
Brooke Courtney: FDA views the summit as an unparalleled opportunity each year to engage with stakeholders at the state, local and federal levels—to share with them updates from the federal side and also for us to get feedback from them about challenges and successes. We engage with stakeholders on a regular basis, but this is really the meeting where the largest number of people involved in preparedness come together, and it’s a great opportunity to see people face-to-face.
We feel really fortunate to have been able to take part in the summit for the past few years. For this year’s summit FDA served on the Planning Committee and also participated in the medical countermeasure policy town hall with federal colleagues from the Office of the Assistant Secretary for Preparedness and Response, the U.S. Department of Homeland Security and the national security staff, all of whom we work with closely.
Another thing that we like to do at the summit each year is to give a more in-depth update through a session with the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department for Health and Human Services (HHS) legal counsel on the authorities that we have that we use related to the emergency use of medical countermeasures during emergencies. This year’s session was especially exciting for us because it was an opportunity for us to discuss with stakeholders some new authorities that were established in 2013 to enhance preparedness and response flexibility.
For example, we can now clearly issue emergency use authorizations in advance of emergencies, which is really a critical medical countermeasure tool for preparedness purposes. Through these flexibilities, for example, we’ve issued three emergency use authorizations in the past year for three different in-vitro diagnostic tests to address the emerging threats of H7 and 9 influenza and MERS-CoV.
NPH: What are the key responsibilities the FDA has in helping to prepare the United States for possible disasters?
Courtney: As an agency of the U.S. Department of Health and Human Services, the FDA, at its core, is a public health agency. FDA’s mission is to protect and promote public health in a number of critical ways. We’re responsible for regulating more than $1 trillion in consumer goods annually, ranging from medical products such as drugs and vaccines to tobacco and food products.